Is it neces­sary to perform ir­rigation of a haematoma dur­­ing the operation of a chronic subdural haematoma via burr hole drainage?


Authors: P. Stejskal;  M. Vaverka;  L. Hrabálek;  M. Hampl;  Š. Trnka;  V. Novák;  J. Jablonský;  M. Halaj
Authors‘ workplace: Neurochirurgická klinika LF UP, a FN Olomouc
Published in: Cesk Slov Neurol N 2019; 82(4): 448-451
Category: Original Paper
doi: 10.14735/amcsnn2019448

Overview

Aim: There are a lot of modifications for the surgical treatment of chronic subdural haematoma; however, the burr hole drainage is the most common procedure. The aim of our study was to compare two particular surgical procedures: burr hole drainage with preoperative irrigation of the haematoma and simple burr hole drainage.

Patients and methods: Patients who were operated on the chronic subdural haematoma at our department between 2011–2016 were enrolled in the study. Burr hole drainage with irrigation was used till September 2013; since then, patients have undergone burr hole drainage without irrigation. This change in surgical technique at out department was influenced by the studies showing similar results of both surgical techniques. Thus, the distribution of patients according to the surgical technique was not influenced by selection bias. All the data needed for the evaluation of the results of both surgical techniques, especially focusing on assessing recurrences, were found retrospectively in the medical documentation.

Results: There were 230 patients in our study who were treated by one of two study procedures. Eightyone patients underwent surgery with irrigation of haematoma, out of which 19 patients (23.5%) developed recurrence and 4 patients (4.9%) had to finally undergo craniotomy and membranectomy. The surgical technique without irrigation of haematoma was performed in 149 patients, and the recurrence was observed in 42 patients (28.2%) and 9 patients (6.0%) had to undergo craniotomy and membranectomy. Statistical evaluation did not prove a significant difference in effectiveness between these two surgical techniques.

Conclusion: Simple burr hole drainage is as effective as burr hole drainage with irrigation according to up to date knowledge. The technique without irrigation, as less invasive and faster, seems to be better for the treatment of chronic subdural haematoma.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Keywords:

chronic subdural haematoma – burr hole drainage – irrigation of the haematoma – recurrence


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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